MEDICARE: MRS. LINSEY PATRICIA OLSON MSPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1822	MT

General Provider Information

NPI Number	:	1467441402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINSEY PATRICIA OLSON MSPT

Provider Business Mailing Address
First Line	:	4807 SCOTT ALLEN DR
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59803-2793
Country	:	US
Telephone Number	:	406-542-0808
Fax Number	:

Provider Business Practice Location Address
First Line	:	2360 MULLAN RD
Second Line	:	SUITE D
City	:	MISSOULA
State	:	MT
Zip	:	59808-1811
Country	:	US
Telephone Number	:	406-542-0808
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	07/08/2007

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